Improved medical management has increased survival rates of preterm newborn infants. However, these children increasingly show impaired cognition which is associated with decreases in cerebellar volume. Because animals models have shown reduced preterm cerebellar growth after perinatal exposure to glucocorticoids, the authors investigated the effects of glucocorticoid exposure on human preterm infant brain. Serial magnetic resonance imaging showed that postnatal exposure to clinically routine doses of hydrocortisone or dexamethasone was associated with impaired cerebellar, but not cerebral, growth. The authors suggest that alterations in treatment after preterm birth, particularly glucocorticoid exposure, may help to decrease risk for adverse neurological outcome after preterm birth. In preterm infants, antenatal treatment with glucocorticoid is routinely used to enhance preterm lung maturation. Postnatal glucocorticoid is used for persistent hypotension presumed to be due to adrenal insufficiency, or prolonged dependence on intubation to manage subglottic stenosis or bronchopulmonary dysplasia.
Tam EWY, Chau V, Ferriero DM, Barkovich AJ, Poskitt KJ, Studholme C, Fok ED, Grunau RE, Glidden DV, Miller SP: Preterm Cerebellar Growth Impairment After Postnatal Exposure to Glucocorticoids. Science Translational Medicine vol.3 , issue 105: p.105ra105 (2011).
